WI0100119_Regional Office Physical File Scan Up To 9/14/2022

A AM
MCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 14, 2010
Chris Hedden
73 Holly Hill Vista Rd
Franklin, NC 28734
ourcet V 01 2010
Asheville RegioragOMuon
Aquifer Rrotect&Fretary
Subject: Issuance of Injection Well Permit
Permit No. WI0100119
Issued to Chris D. Hedden
Macon County
Dear Mr. Hedden:
In accordance with your application received September 9, 2010, I am forwarding Permit No. WI0100119
for the construction and operation of a vertical closed -loop geothermal mixed -fluid heat pump injection
well system located at 10305 Bryson City Rd., Franklin, Macon County, NC, 28734. This permit shall be
effective from the date of issuance until September 30, 2015, and shall be subject to the conditions and
limitations stated therein.
Please pay special attention to Part I.7 of the permit and submit copies of the Well Construction
Completion form (GW-1) after construction. Please submit all data within 30 calendar days of receipt of
this letter to the address below:
Aquifer Protection Section (APS)
Underground Injection Control (UIC) Staff
1636 Mail Service Center
Raleigh, NC 27699-1636
Additionally, your UIC system is subject to inspection by the APS and at the time of the inspection must
display a permanently affixed identification plate in accordance with requirements of 2C .0213(g). Please
insure this is completed in accordance with permit condition Part I.6 of this permit issued October 1,
20.10.
In order to continue uninterrupted legal use of this well for the stated purpose, you should submit an
application to renew the permit three months prior to its expiration date. As indicated in the permit, this
permit is not transferable to any person without prior notice to, and approval by, the Director of the
Division of Water Quality. If you have any questions regarding your permit or the Underground Injection
Control Program please call me at [phone].
Sincerely,
John McCray,
Environmental Specialist

cc: Landon -Davidson Asheville Regional Office'
Central Office File— WI0100119
Macon County Environmental Health Dept.
Corbin and McMahan
Enc: Permit WI0100119

pr
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and other applicable
Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Chris D. Hedden
FOR THE CONSTRUCTION AND OPERATION OF 4 TYPE 5QM INJECTION WELL, defined in Title 15A
North Carolina Administrative Code 2C .0209(e)(3)(F), for the purpose of operating a vertical closed -loop
geothermal -mixed -fluid heat pump system. This system is located at 10305 Bryson City Rd., Franklin, Macon
County, NC 28734, and will be constructed and operated in accordance with the application received September
9, 2010, and in conformity with the specifications and supporting data submitted, all of which are filed with the
Department of Environment and Natural Resources and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the Water Use Act or
any other applicable Laws, Rules, or Regulations. Operation and use of an injection well shall be in compliance
with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and any other Laws, Rules, and
Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until September 30, 2015, and shall
be subject to the specified conditions and limitations set forth in Parts I through IX hereof.
.1_�
Permit issued this the c� k day of O&�, 2010.
oleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
11
1. The Permittee must comply with all conditions of this permit and with the standards and criteria specified
in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any noncompliance with
conditions of this permit constitutes a violation of the North Carolina Well Construction Act and is
grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall not be located in an area generally subject to flooding. Areas that are generally
subject to flooding include those with concave slope, alluvial or colluvial soils, gullies, depressions, and
drainage ways.
5. Each injection well shall be afforded reasonable protection against damage during construction and use.
6. Each geothermal injection well system shall have permanently affixed an identification plate on a nearby
building or other permanently fixed structure indicating the location and presence of underground UIC
wells according to 2C .0213(g).
7. A completed Well Construction Record (Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section — UIC Staff
1636 Mail Service Center
Raleigh, NC 27699-1636
and
Aquifer Protection Section — Asheville Regional Office
2090 U.S. 70 Highway
Swannanoa, NC 28778
[phone]
GW-1 s must be submitted within 30 days of completion of well construction. Copies of the GW-1
form(s) shall be retained on -site and available for inspection.
Well construction records must also be submitted for the existing water supply wells on -site as well as a
site map showing any water supply wells on adjacent properties as specified in NCAC .0211(d)(1)(1)).
PART II — WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight (48) hours prior to constructing system, the Permittee shall notify the Aquifer
Protection Section's Underground Injection Control (UIC) Program Central Office staff, telephone
number [phone] and the Asheville Regional Office Aquifer Protection Section Staff, telephone
number (828) 296-4.500. V
WI0100119 2

Boreholes shall not connect separate aquifers which have differences in water quality (e. i)., shallow
surficial aquifers, saprolite, fractured. bedrock, etc.) as specified in 15A NCAC 2C .0213(d)(8)(C) and
shall be filled with bentonite grout from the lowermost water bearing zone to land surface as specified in
the permit application.
PART III — OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials and rate of injection, as
described in the application and other supporting data.
2. This permit is not transferable -without prior notice to, and approval by, the Director of the Division of
Water Quality (Director). In the event there is a desire for the facility to -change ownership, or there is.a
name change of the Permittee, a formal permit amendment request must be submitted to the Director,
including any supporting materials as may be appropriate, at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with any and
all statutes, rules, regulations, or ordinances, which may be imposed by other local, state, and federal
agencies, which have jurisdiction. Furthermore, the issuance of this permit does not imply that all
regulatory requirements have been met. -
PART IV — PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater that will render it unsatisfactory for normal use. In the event that the
facility fails to perform satisfactorily, including the creation of nuisance conditions or failure of the
injection zone to adequately assimilate the injected fluid, the Permittee shall take immediate corrective
actions including those actions that may be required by the Division of Water Quality such as the repair,
modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if compliance
requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to surface or
groundwater resulting from the operation of this facility.
PART V — OPERATIONS AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of any
planned physical alterations or additions in the permitted facility or activity not specifically authorized by
the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection, the
Permittee must notify by telephone the Aquifer Protection Section's Underground Injection Control (UIC)
Program Central Office staff, telephone number [phone]. Notification is required so that Division
staff can inspect or otherwise review the injection facility and determine if it is in compliance with permit
conditions.
WI0100119 3

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to the injection
facility at any reasonable time for the purpose of determining compliance with this permit, may inspect or
copy any records that must be maintained under the terms and conditions of this permit, and may obtain
samples of groundwater, surface water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation, and
sampling associated with injection and any related facilities as provided for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated with the
injection facility activities.
PART VII — MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
2. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of the
occurrence, to the Asheville Regional Office, telephone number [phone], any of the following:
(A) Any occurrence at the injection facility that results in any unusual operating circumstances;
(B) Any failure due to known. or unknown reasons that renders the facility incapable of proper
injection operations, such as mechanical or electrical failures;
3. Where the Permittee becomes aware of an omission of any relevant facts in a permit application, or of any
incorrect information submitted in said application or in any report to the Director, the relevant and
correct facts or information shall be promptly submitted to the Director by the Permittee.
4. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII — PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an extension.
PART IX — CHANGE OF WELL STATUS
1 The Permittee shall provide written notification within 15 days of any change of status of an injection
well. Such a change would include the discontinued use of a well for injection. If a well is taken
completely out of service temporarily, the Permittee must install a sanitary seal. If a well is not to be used
for any purpose that well must be permanently abandoned according to 15A NCAC 2C .0213(h)(1), Well
-Construction Standards.
WI0100119 4

When operations have ceased at the facility and a well will no longer be used for any purpose, the
Permittee shall abandon that injection well in accordance with the procedures specified in 15A NCAC 2C
.0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of abandonment procedures if
the Director finds such removal will not be responsible for, or contribute to, the
contamination of an underground source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) Each well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to do so could lead to the contamination of an underground source of drinking
water.
(D) Each well shall be completely filled with cement grout, which shall be introduced into the
well through a pipe which extends to the bottom of the well and is raised as the well is
filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, the casing shall be perforated opposite the gravel pack, at intervals not
exceeding 10 feet, and grout injected through the perforations.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each well shall be abandoned in such a manner that will prevent the movement of
fluids into or between underground sources of drinking water and in accordance with the
terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Program
DENR-Division of Water Quality
1636 Mail Service Center "
Raleigh, NC 27699-1636
WI0100119 5

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{
41
NCDENR
North Carolina Department of Environment and N
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
September 21, 2010
Chris D Hedden
73 Holly Hill Vista Rd.
Franklin, NC 28734
Subject: Acknowledgement of Application No. WI0100119
Chris D Hedden SFR
Injection Mixed Fluid GSHP Well System (5QM)
Macon
Dear Mr. Hedden:
Resou C. ces 12 26 i0
Asheville Reglonal
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit application and
supporting materials on September 9, 2010. This application package has been assigned the number listed above and will be reviewed
by John McCray.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary. To ensure the
maximum efficiency in processing permit applications, the Division requests your assistance in providing a timely and complete
response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final action by the
Division. Please also note at this time, processing permit applications can take as long as 60 - 90 days after receipt of a complete
application.
If you have any questions, please contact John McCray at 919-715-6168, or via e-mail [e-mail]. If the reviewer is
unavailable, you may leave a message, and they will respond promptly. Also note that the Division has reorganized. To review our
new organizational chart, go to hllp:Hh2o.enr.state.nc.us/documents/dwq_orYchart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS PROJECT.
Sincer jy,
for Debra J. Watts
Supervisor
cc: Ashevil_le'Regfonal Of_f ce, Aquifer Protection Section-1
Corbin & McMahan (7355 Sylva Rd., Franklin, NC 28734)
Permit Application File WI0100119
AQUIFER PROTECTION SECTION
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Location: 2728 Capital Boulevard, Raleigh, North Carolina 27604
Phone: [phone] \ FAX 1: 919-715-0588; FAX 2: 919-715-6048 \ Customer Service: 1-877-623-6748
Internet: www.nmaterguality.ora
An Equal Opportunity \ Affirmative .Action Employer
One
NorthCc` rolina
Amullally

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES (NCDENR)
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR
INJECTION WITH A GEOTHERMAL HEAT PUMP SYSTEM FOR:
TYPE 50M_WELL(S).
_New Permit Application OR Renewal (check one)
DATE: 2010
PERMIT NO. (leave blank if NEW permit application)
A.. PROPERTY. OWNERS)/APPLICANT(S)
List each Property Owner listed on property deed (if owned by a business or government agency, state name of
entity and a representative w/authority for signature): cf-I R is 1J • k e pr7 ctj
(1) Mailing Address: (3 (4a i (4 JA; R Vi 5rx 'RD
City: State: C Zip Code: ?A County: M4L&A
Home/Office Tele No.: 8 Z8 r 364 - 9 5'9.1 Cell No.:
EMAIL Address: �tr�s11 2t7 %1Kg h Qs..Jef- '
(2) Physicall Address of Site (if different than above): d 30� b(C.USorj. C,' Zl K o
City: !r-/< IC(.iAJ State: C: Zip Code: - %_County: A14-G,7
Home/Office Tele No.: Cell No.:
EMAIL Address:
B. AUTHORIZED AGENT OF OWNER, IF ANY (if the Permit Applicant does not own the subject property,
attach a letter from the property owner authorizing Agent to install and operate UIC. well)
Company Name: 14eo)Ek� 8jzw. welt ) l2i Lf!i,yo'.
Contact Person.,s EMAIL Address:
Address:�73 i-i 01(� W I I ` 1 sTW "Ro /
City:-(-��i4 i,J k.�.1 pJ State: IVL Zip Code: 3'P County: JM A God
Office Tele No.; Cell No.:
Website Address of Company, if any: _
C. STATUS OF APPLICANT RECEIVED / DENR % DWQ
Aquifer Protection Section
Private:- ✓A Federal: Commercial:
State: Municipal: Native American Lands: SEP 0 9 2010, .
GPU/UIC 5QM Well Permit Application (Revised 7/2008) Page 1

D. WELL DRILLER IIINFORMATION
Company Name:,-t�'�Drr i-� �f24S. C L :�,2i liBN4 _ T1JC
Well Drilling Contractor's Name: C042i 5 4eDPP---,3
NC Contractor Certification No.: 24) A- ��rr�
Contact Person: Cl0 5 14EpD tc A EMAIL Address: L. n's h P. hush-dJ,,JAl,
Address: 73ltxtti J( Viino.,—go
.
City:Zip Coders County:
Office Tele No.: RZ8 - 3rct 'Ciro ( Cell No.:
E. HEAT PUMP CONTRACTOR n^INFORMATION (if different than driller)'.
Company Name: CoR3„ -) 4+ " I � ` C MA H A-..)
Contact Person: EMAIL Address:
Address: _% 3!55 Sy tMA- R•O
City: FkAN LUIJ.. Zip Code: " #J"C County: IM4caa :
Office Tele No.:" 826 -30 ' 8 %SO . Cell No :
F. INJECTION PROCEDURE (briefly describe how. the injection well(s) will be used) .
G. WELL CONSTRUCTION DATA (Skip to Section H if this is a Permit RENEWAL)
(1) Proposed date to be constructed.`,!!jep'• ZO l O" Number of borings: Ll
Approximate depth of each boring (feet): 22 C> "
(2) Chemical additives to e used in closed -loop system (only those chemicals indicated have been approved):
R-22 propylene glycol ethanol other (other additives will,
need prior approval by NCDENR before use)
(3) Type of tubing to be used (copper, PVC, etc):D�Er
(4) Well casing: Is the well(s) cased? (check either (a.) YES or (b.) NO below)
(a) YES if yes, then provide casing information such as type (steel, PVC, plastic, etc.), diameter,
depth, and extent of casing appearing above ground:
(b) NO 1%
(5) Grout (material surrounding well casing and/or piping):
(a) Grout type: Cement Bentonite _1 Other (specify) !i /i c s '574e+D
(b) Grout depth of tubing (reference to laird surface): from ` to 22 D (feet) "
If well has casing, indicate grout depth: from to'. __(feet)
H. INJECTION -RELATED EQUIPMENT
Attach a diagram showing the engineering layout or. proposed modification of the. injection equipment and exterior
piping/tubing associated 'with the injection operation..;. The manufacturer's.brochure. may provide, supplementary
information.
GPU/UIC 5QM Well Permit Application (Revised 7/2008) Page 2

I., LOCATION OF WELL(S)
Attach two copies of maps showing the following information:
(1) Include a site map (can be drawn) showing: buildings, property lines, surface water bodies,- potential sources
of groundwater contamination and. the orientation of and distances between the proposed well(s), and any
existing well(s) or waste disposal facilities such as -septic tanks or drain, fields located within 1000 feet ofithe
geothermal heat pump well system. Label all features clearly and include a north arrow.
(2) Include a topographic map of the area extending one mile. from the property boundaries and
indicate the facility's location and the map name.
Q
J. POTABLE WATER WELL(S)
Are there any potable water well(s) on the subject property or adjacent properties? ✓ YES NO
If Yes, than indicate location on attached map(s).
K. CERTIFICATION.
Note: This Permit Application must be signed by each`person appearing on the recorded legal property deed.
"I hereby certify, under penalty .of law, that I have personally examined and am familiar': with the'. information
submitted in this document and all attachments thereto and. that, based on my inquiry "of those- individuals "
immediately responsible for obtaining said information, I believe that the information is true, accurate and complete.
I am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting
false information. I agree to construct, operate, maintai , repair, and if applicable, abandon the injection well and
all related appurtenances in accordance with t ppr specifications and conditions of the, Permit."
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Property Owner/Applicant
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Please return two copies of the completed Application"package to;
RECEIVED / DE
NR / p
INQ
North Carolina DENR-DWQ Aquifer Protection, Section
Aquifer Protection Section SEP 09'O�o
UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
GPU/UIC 5QM Well Permit Application (Revised 7/2008) Page 3 .

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Oct,13. 2010 2:32PM HEDDEN BROS WELL DRILLING No-9398 P• 1
: ALL: DR,L'L.I,NQ iNC
73 Holly Hills Vista Rd,
Franklin.,.NC 28734 �. 'E9 r�
(Tel) 8.28-369 '9591
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